I am 51 years old and I am going through the Peri-menopause. I'm a vegetarian and a runner but recently I've been feeling very low. I have taken menopause support and valerian when necessary, but I am still struggling with hot flushes and I am constantly lacking sleep as a consequence Can you help me?

The hormonal changes during the menopause can put tremendous strain on the body and this, in itself, can contribute to menopause symptoms such as flushes, poor sleep, low mood, and fatigue. 

It is very important to look after yourself well at this time, and to make sure that your nutritional needs are being met.Make sure that you are eating a good, varied diet with plenty of fresh foods and lots of water - dehydration can cause fatigue, and if you are getting hot flushes, it's doubly important to keep drinking!

Rest and relaxation are vital and I know it can be very difficult if you lead a busy life, but do make 30 minutes a day your me-time - this can reduce symptoms very quickly!

Sensible exercise is important but don't go overboard. Combining a lot of exercise with the stress of the menopause could be the cause of your fatigue.

If you need to keep running, it would be really important to take a proper sports nutrition supplement every day.

Also protein needs often get higher at this time, so if you are vegetarian it would be an idea to take a protein powder shake every day too. Just check that it doesn't contain sugar or artificial sweeteners.

Eileen Durward